Arch Intern Med
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We studied 211 sets of pulmonary function data to evaluate spirographic findings in patients with restrictive defects, and to determine the significance of the spirographic interpretation of restriction. A combination of clinical and body plethysmographic data was used as the standard for the diagnosis of restriction. ⋯ Ten percent of patients with pure obstructive defects by clinical and plethysmographic criteria showed a restrictive defect on the spirogram. Combined obstructive and restrictive defects were rare; in these cases the spirogram showed a restrictive defect but missed the obstructive component.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiopulmonary resuscitation (CPR) training. Consequences for family members of high-risk cardiac patients.
A prospective, controlled trial was conducted to document the psychological risks and benefits of teaching cardiopulmonary resuscitation (CPR) techniques to family members of patients at high risk for a sudden death event. Clinical outcomes for the high-risk patients were also measured. Cardiac patients (n = 65) and their family members (n = 69) were randomized to one of three groups: CPR training, risk factor education, and control. ⋯ The patients in the CPR group, however, were more anxious at three months' follow-up than patients in either the educational or control groups. Patients in both CPR and risk factor education groups reported poorer adjustment to illness at six months' follow-up than did control patients. These results suggest that CPR training for family members may have an adverse psychological effect on high-risk cardiac patients.
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An osmolal gap (a disparity between measured and calculated serum osmolality) may accompany alcohol intoxication. We encountered a patient with methanol toxicity in whom no such gap was present, despite a markedly elevated serum methanol level. ⋯ In vitro testing confirmed the insensitivity of vapor pressure osmometry to toxic ranges of both methanol and ethanol. When alcohol toxicity is suspected, an osmolal gap should be sought only if freezing point osmometry is available.